An Atlas of Amplitude-Integrated EEGs in the Newborn

Third Edition

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Case 3.1

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Question 1 of 4

1. Question
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Full-term infant born at 40 weeks’ gestation by cesarean section following failed ventouse extraction. Apgar scores 1, 3 and 3 at 1, 5 and 10 minutes. The umbilical arterial pH was 7.15, with a BE -12 mmol/L. The Thompson score was 16 and hypothermia was started. You connected the baby to the aEEG which showed the following.

What is your first impression of this aEEG recording?

Continuous low voltage background in F3-P3 and burst suppression on F4-P4

Flat trace on F3-P3 and burst suppression on F4-P4

Not entirely sure, would like to check the raw EEG as well

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Question 2 of 4

2. Question
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Besides looking at the raw EEG it is also worthwhile to have a video. In this case the video showed that the head was positioned with the head turned to the right side. Assessing the F3-P3 would therefore be more reliable. A continuous low voltage is the best answer for the F3-P3 recording. For the P4-F4 we also have to look at the raw EEG, that is shown here:

What is your impression now for P4-F4

Burst suppression with superimposed seizure

Burst suppression with possible artefact

I am not sure and would like to see more than these 12 seconds of EEG

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Question 3 of 4

3. Question
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We now changed the scale from 30 mm/sec to 15 mm/sec.

What is your interpretation now?

Seizures

Not Seizures

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Question 4 of 4

4. Question
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You now also have access to the heart rate and respiration as well (Video)

What is your interpretation now?

This is a seizure

This is Respiration Artifact

This is an EKG Artifact

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An Atlas of Amplitude-Integrated EEGs in the Newborn

Third Edition

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